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Chaves-Filho AJM, Soares MVR, Jucá PM, Oliveira TDQ, Clemente DCDS, Monteiro CEDS, Silva FGO, de Aquino PEA, Macedo DS. Doxycycline reversal of amphetamine-induced mania-like behavior is related to adjusting brain monoamine abnormalities and antioxidant effects in primary hippocampal neurons. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024:10.1007/s00210-024-03009-7. [PMID: 38386042 DOI: 10.1007/s00210-024-03009-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 02/12/2024] [Indexed: 02/23/2024]
Abstract
Mania is associated with disturbed dopaminergic transmission in frontotemporal regions. D-amphetamine (AMPH) causes increased extracellular DA levels, considered an acknowledged mania model in rodents. Doxycycline (DOXY) is a second-generation tetracycline with promising neuroprotective properties. Here, we tested the hypothesis that DOXY alone or combined with Lithium (Li) could reverse AMPH-induced mania-like behavioral alterations in mice by the modulation of monoamine levels in brain areas related to mood regulation, as well as cytoprotective and antioxidant effects in hippocampal neurons. Male Swiss mice received AMPH or saline intraperitoneal (IP) injections for 14 days. Between days 8-14, mice receive further IP doses of DOXY, Li, or their combination. For in vitro studies, we exposed hippocampal neurons to DOXY in the presence or absence of AMPH. DOXY alone or combined with Li reversed AMPH-induced risk-taking behavior and hyperlocomotion. DOXY also reversed AMPH-induced hippocampal and striatal hyperdopaminergia. In AMPH-exposed hippocampal neurons, DOXY alone and combined with Li presented cytoprotective and antioxidant effects, while DOXY+Li also increased the expression of phospho-Ser133-CREB. Our results add novel evidence for DOXY's ability to reverse mania-like features while revealing that antidopaminergic activity in some brain areas, such as the hippocampus and striatum, as well as hippocampal cytoprotective effects may account for this drug's antimanic action. This study provides additional rationale for designing clinical trials investigating its potential as a mood stabilizer agent.
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Affiliation(s)
- Adriano José Maia Chaves-Filho
- Neuropharmacology Laboratory, Drug Research and Development Center, Department of Physiology and Pharmacology, Faculty of Medicine, Universidade Federal do Ceará, Rua Cel. Nunes de Melo 1000, Fortaleza, CE, 60431-270, Brazil
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - Michele Verde-Ramo Soares
- Neuropharmacology Laboratory, Drug Research and Development Center, Department of Physiology and Pharmacology, Faculty of Medicine, Universidade Federal do Ceará, Rua Cel. Nunes de Melo 1000, Fortaleza, CE, 60431-270, Brazil
| | - Paloma Marinho Jucá
- Neuropharmacology Laboratory, Drug Research and Development Center, Department of Physiology and Pharmacology, Faculty of Medicine, Universidade Federal do Ceará, Rua Cel. Nunes de Melo 1000, Fortaleza, CE, 60431-270, Brazil
| | - Tatiana de Queiroz Oliveira
- Neuropharmacology Laboratory, Drug Research and Development Center, Department of Physiology and Pharmacology, Faculty of Medicine, Universidade Federal do Ceará, Rua Cel. Nunes de Melo 1000, Fortaleza, CE, 60431-270, Brazil
| | - Dino Cesar da Silva Clemente
- Neuropharmacology Laboratory, Drug Research and Development Center, Department of Physiology and Pharmacology, Faculty of Medicine, Universidade Federal do Ceará, Rua Cel. Nunes de Melo 1000, Fortaleza, CE, 60431-270, Brazil
| | - Carlos Eduardo da Silva Monteiro
- Laboratory of Physiopharmacology Study of Gastrointestinal Tract, Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Francisca Géssica Oliveira Silva
- Laboratory of Physiopharmacology Study of Gastrointestinal Tract, Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Pedro Everson Alexandre de Aquino
- Neuropharmacology Laboratory, Drug Research and Development Center, Department of Physiology and Pharmacology, Faculty of Medicine, Universidade Federal do Ceará, Rua Cel. Nunes de Melo 1000, Fortaleza, CE, 60431-270, Brazil
| | - Danielle S Macedo
- Neuropharmacology Laboratory, Drug Research and Development Center, Department of Physiology and Pharmacology, Faculty of Medicine, Universidade Federal do Ceará, Rua Cel. Nunes de Melo 1000, Fortaleza, CE, 60431-270, Brazil.
- National Institute for Translational Medicine (INCT-TM, CNPq), São Paulo, Brazil.
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Cognitive dysfunction in SLE: An understudied clinical manifestation. J Autoimmun 2022; 132:102911. [PMID: 36127204 DOI: 10.1016/j.jaut.2022.102911] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 11/22/2022]
Abstract
Neuropsychiatric lupus (NPSLE) is a debilitating manifestation of SLE which occurs in a majority of SLE patients and has a variety of clinical manifestations. In the central nervous system, NPSLE may result from ischemia or penetration of inflammatory mediators and neurotoxic antibodies through the blood brain barrier (BBB). Here we focus on cognitive dysfunction (CD) as an NPSLE manifestation; it is common, underdiagnosed, and without specific therapy. For a very long time, clinicians ignored cognitive dysfunction and researchers who might be interested in the question struggled to find an approach to understanding mechanisms for this manifestation. Recent years, however, propelled by a more patient-centric approach to disease, have seen remarkable progress in our understanding of CD pathogenesis. This has been enabled through the use of novel imaging modalities and numerous mouse models. Overall, these studies point to a pivotal role of an impaired BBB and microglial activation in leading to neuronal injury. These insights suggest potential therapeutic modalities and make possible clinical trials for cognitive impairment.
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Morley KC, Baillie A, Van Den Brink W, Chitty KE, Brady K, Back SE, Seth D, Sutherland G, Leggio L, Haber PS. N-acetyl cysteine in the treatment of alcohol use disorder in patients with liver disease: Rationale for further research. Expert Opin Investig Drugs 2018; 27:667-675. [PMID: 30019966 DOI: 10.1080/13543784.2018.1501471] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Alcoholic liver disease (ALD) is the leading cause of alcohol-related death and one of the most common forms of liver disease. Abstinence from alcohol is crucial to reducing morbidity and mortality associated with the disease. However, there are few pharmacotherapies for alcohol use disorder suitable for those with significant liver disease. AREAS COVERED This paper presents a rationale for investigating the use of N-acetyl cysteine (NAC) to promote abstinence or reduce heavy alcohol consumption for patients with an alcohol use disorder, particularly in the presence of liver disease. NAC is an antioxidant with glutamatergic modulating and anti-inflammatory properties. Evidence is emerging that oxidative stress, neuro-inflammation and dysregulation of glutamatergic neurotransmission play a key role in alcohol use disorder. Similarly, oxidative stress is known to contribute to ALD. We outline the studies that have investigated NAC to reduce alcohol consumption including preclinical and clinical studies. We also review the evidence for NAC in other addictions as well as psychiatric and physical comorbidities associated with alcohol use disorders. EXPERT OPINION NAC is low cost, well-tolerated and could have promise for the treatment of alcohol use disorder in the presence of liver disease. Clinical trials directly examining efficacy in this population are required.
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Affiliation(s)
- Kirsten C Morley
- a University of Sydney, Faculty of Medicine and Health, Central Clinical School , NHMRC Centre of Research Excellence in Mental Health and Substance Use , Sydney , NSW , Australia
| | - Andrew Baillie
- b NHMRC Centre of Research Excellence in Mental Health and Substance Use, Faculty of Health Sciences , University of Sydney , Sydney , NSW , Australia
| | - Wim Van Den Brink
- c Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands
| | - Kate E Chitty
- d Faculty of Medicine and Health, Discipline of Pharmacology , University of Sydney, Clinical Pharmacology and Toxicology Research Group , Sydney , NSW , Australia
| | - Kathleen Brady
- e South Carolina Clinical and Translational Research Centre , Medical University of South Carolina , Charleston , United States of America
| | - Sudie E Back
- f Department of Psychiatry and Behavioral Sciences , Medical University of South Carolina , Charleston
| | - Devanshi Seth
- g The University of Sydney, Centenary Institute , Camperdown , NSW , Australia
| | - Greg Sutherland
- h Faculty of Medicine and Health, Discipline of Pathology , University of Sydney , Sydney , NSW , Australia
| | - Lorenzo Leggio
- i Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse , National Institutes of Health , Bethesda , MD , USA.,j Center for Alcohol and Addiction Studies , Brown University , Providence , RI , USA
| | - Paul S Haber
- a University of Sydney, Faculty of Medicine and Health, Central Clinical School , NHMRC Centre of Research Excellence in Mental Health and Substance Use , Sydney , NSW , Australia.,k Drug Health Services , Royal Prince Alfred Hospital , Camperdown , NSW , Australia
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Roberts-Wolfe DJ, Kalivas PW. Glutamate Transporter GLT-1 as a Therapeutic Target for Substance Use Disorders. CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS 2016; 14:745-56. [PMID: 26022265 DOI: 10.2174/1871527314666150529144655] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 05/18/2015] [Indexed: 12/13/2022]
Abstract
The development of new treatments for substance use disorders requires identification of targetable molecular mechanisms. Pathology in glutamatergic neurotransmission system in brain reward circuitry has been implicated in relapse to multiple classes of drugs. Glutamate transporter 1 (GLT-1) crucially regulates glutamatergic signaling by removing excess glutamate from the extrasynaptic space. The purpose of this review is to highlight the effects of addictive drug use on GLT-1 and glutamate uptake, and using GLT-1 as a target in addiction pharmacotherapy. Cocaine, opioids, ethanol, nicotine, amphetamines, and cannabinoids each affect GLT-1 expression and glutamate uptake, and restoring GLT-1 expression with N-acetylcysteine or ceftriaxone shows promise in correcting pre-clinical and clinical manifestations of drug addiction.
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Affiliation(s)
- Douglas J Roberts-Wolfe
- Department of Neuroscience, Medical University of So Carolina, 173 Ashley Ave, BSB403, Charleston, SC 29425, USA.
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Garcia RJ, Francis L, Dawood M, Lai ZW, Faraone SV, Perl A. Attention deficit and hyperactivity disorder scores are elevated and respond to N-acetylcysteine treatment in patients with systemic lupus erythematosus. ACTA ACUST UNITED AC 2013; 65:1313-8. [PMID: 23400548 DOI: 10.1002/art.37893] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 01/31/2013] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To investigate whether attention deficit hyperactivity disorder (ADHD) may serve as a marker of neuropsychiatric disease and as a target for N-acetylcysteine (NAC) treatment in patients with systemic lupus erythematosus (SLE). METHODS The ADHD Self-Report Scale (ASRS) was used to assess 49 patients with SLE and 46 matched healthy control subjects. Twenty-four of the patients with SLE were randomized to receive either placebo, NAC at a dosage of 2.4 gm/day, or NAC at a dosage of 4.8 gm/day. Disease activity was evaluated monthly using the British Isles Lupus Assessment Group (BILAG) index, the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), the Fatigue Assessment Scale (FAS), and the ASRS, before and during the 3-month treatment period and after a 1-month washout period. RESULTS The cognitive/inattentive (ASRS part A), hyperactivity/impulsive (ASRS part B), and combined (total) ASRS scores were increased in patients with SLE compared with control subjects (mean ± SEM 17.37 ± 1.03 [P = 3 × 10(-7) ], 14.51 ± 0.89 [P = 2 × 10(-4) ], and 31.92 ± 1.74 [P = 8 × 10(-7) ], respectively, versus 10.41 ± 1.02, 9.61 ± 1.21, and 20.02 ± 1.98, respectively. ASRS part A scores correlated with SLEDAI (r = 0.53, P < 0.0001) and BILAG scores (r = 0.36, P = 0.011). ASRS total scores also correlated with SLEDAI (r = 0.45, P = 0.0009) and BILAG scores (r = 0.31, P = 0.025). ASRS part A (r = 0.73, P < 0.0001), ASRS part B (r = 0.47, P = 0.0006), and ASRS total scores (r = 0.67, P < 0.0001) correlated with the FAS score. Relative to the scores in placebo-treated patients, ASRS total scores were reduced in SLE patients treated with NAC dosages of 2.4 gm/day and 4.8 gm/day combined (P = 0.037). ASRS part A scores were reduced by NAC dosages of 2.4 gm/day (P = 0.001) and 4.8 gm/day (P < 0.0001) as well as by NAC at dosages of 2.4 gm/day and 4.8 gm/day combined (P = 0.001). CONCLUSION In patients with SLE, elevated ASRS scores reveal previously unrecognized and clinically significant symptoms of ADHD that respond to NAC treatment.
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Affiliation(s)
- Ricardo J Garcia
- State University of New York Upstate Medical University, Syracuse 13210, USA
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Berk M, Dean OM, Cotton SM, Gama CS, Kapczinski F, Fernandes B, Kohlmann K, Jeavons S, Hewitt K, Moss K, Allwang C, Schapkaitz I, Cobb H, Bush AI, Dodd S, Malhi GS. Maintenance N-acetyl cysteine treatment for bipolar disorder: a double-blind randomized placebo controlled trial. BMC Med 2012; 10:91. [PMID: 22891797 PMCID: PMC3482580 DOI: 10.1186/1741-7015-10-91] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 08/14/2012] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND N-acetyl cysteine (NAC) is a glutathione precursor that has been shown to have antidepressant efficacy in a placebo-controlled trial. The current study aimed to investigate the maintenance effects of NAC following eight weeks of open-label treatment for bipolar disorder. METHOD The efficacy of a double blind randomized placebo controlled trial of 2 g/day NAC as adjunct maintenance treatment for bipolar disorder was examined. Participants (n = 149) had a Montgomery Asberg Depression Rating Score of ≥12 at trial entry and, after eight weeks of open-label NAC treatment, were randomized to adjunctive NAC or placebo, in addition to treatment as usual. Participants (primarily outpatients) were recruited through public and private services and through newspaper advertisements. Time to intervention for a mood episode was the primary endpoint of the study, and changes in mood symptoms, functionality and quality of life measures were secondary outcomes. RESULTS There was a substantial decrease in symptoms during the eight-week open-label NAC treatment phase. During the subsequent double-blind phase, there was minimal further change in outcome measures with scores remaining low. Consequently, from this low plateau, between-group differences did not emerge on recurrence, clinical functioning or quality of life measures. CONCLUSIONS There were no significant between-group differences in recurrence or symptomatic outcomes during the maintenance phase of the trial; however, these findings may be confounded by limitations. TRIAL REGISTRATION The trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12607000074493).
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Affiliation(s)
- Michael Berk
- Deakin University, School of Medicine, Barwon Health, P.O. Box 291, Geelong, 3220, Australia
- Orygen Youth Health Research Centre, 35 Poplar Rd, Parkville, 3052, Australia
- Centre of Youth Mental Health, University of Melbourne, 35 Poplar Rd, Parkville, 3052, Australia
- Mental Health Research Institute, University of Melbourne, Kenneth Myer Building, 30 Royal Parade, 3052, Parkville, Australia
- University of Melbourne, Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, Parkville, 3052, Australia
| | - Olivia M Dean
- Deakin University, School of Medicine, Barwon Health, P.O. Box 291, Geelong, 3220, Australia
- Mental Health Research Institute, University of Melbourne, Kenneth Myer Building, 30 Royal Parade, 3052, Parkville, Australia
- University of Melbourne, Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, Parkville, 3052, Australia
| | - Sue M Cotton
- Orygen Youth Health Research Centre, 35 Poplar Rd, Parkville, 3052, Australia
- Centre of Youth Mental Health, University of Melbourne, 35 Poplar Rd, Parkville, 3052, Australia
| | - Clarissa S Gama
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, CNPq. Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, 90010-000, Brazil
| | - Flavio Kapczinski
- Laboratory of Molecular Psychiatry, INCT for Translational Medicine, CNPq. Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, 90010-000, Brazil
| | - Brisa Fernandes
- Post-graduate Program in Biological Sciences: Biochemistry, Federal University of Rio Grande do Sul - UFRGS -, Porto Alegre, 90035-000, Brazil
- Laboratory of Calcium Binding Proteins in the Central Nervous System, Department of Biochemistry, Federal University of Rio Grande do Sul - UFRGS -, Porto Alegre, 90035-000, Brazil
| | - Kristy Kohlmann
- Mental Health Research Institute, University of Melbourne, Kenneth Myer Building, 30 Royal Parade, 3052, Parkville, Australia
| | - Susan Jeavons
- Mental Health Research Institute, University of Melbourne, Kenneth Myer Building, 30 Royal Parade, 3052, Parkville, Australia
| | - Karen Hewitt
- Mental Health Research Institute, University of Melbourne, Kenneth Myer Building, 30 Royal Parade, 3052, Parkville, Australia
| | - Kirsteen Moss
- Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, 2006, Australia
- CADE Clinic, Department of Psychiatry, Level 5 Building 36 Royal North Shore Hospital, St. Leonards, 2065, Australia
| | - Christine Allwang
- Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, 2006, Australia
- CADE Clinic, Department of Psychiatry, Level 5 Building 36 Royal North Shore Hospital, St. Leonards, 2065, Australia
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar der TU, München, Ismaninger Str. 22, 81675, Münich, Germany
| | - Ian Schapkaitz
- Mental Health Research Institute, University of Melbourne, Kenneth Myer Building, 30 Royal Parade, 3052, Parkville, Australia
| | - Heidi Cobb
- Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, 2006, Australia
| | - Ashley I Bush
- Mental Health Research Institute, University of Melbourne, Kenneth Myer Building, 30 Royal Parade, 3052, Parkville, Australia
| | - Seetal Dodd
- Deakin University, School of Medicine, Barwon Health, P.O. Box 291, Geelong, 3220, Australia
- University of Melbourne, Department of Psychiatry, Level 1 North, Main Block, Royal Melbourne Hospital, Parkville, 3052, Australia
| | - Gin S Malhi
- Laboratory of Calcium Binding Proteins in the Central Nervous System, Department of Biochemistry, Federal University of Rio Grande do Sul - UFRGS -, Porto Alegre, 90035-000, Brazil
- Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, 2006, Australia
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